EAI Launches Radio Campaign on Single Payer & Medicare

Updated 7:20 pm 10/27/14 (Please check back as we are updating this page as the debate reveals more information.)

On Monday, October 27, the Ethan Allen Institute began running a 60 second radio spot throughout the state about the language in Vermont’s single payer healthcare law (Act 48) as it pertains to Medicare.

Do the creators of Green Mountain Care, Vermont’s single payer health care law, desire and intend to “take over” Medicare by gaining control of federal dollars and assuming the responsibility for administering benefits to seniors?

Summary Timeline of the Issue

It says again, “The agency [of Human Services] shall seek permission from the Centers for Medicare and Medicaid Services to be the administrator for the Medicare program in Vermont.” (33 VSA 1827 (e))

In fairness, proponents of single-payer believe that they can deliver equal or better benefits to seniors through Green Mountain Care, and Act 48 states that by law they must do so. The federal application for the waivers demands that the state demonstrate that it can deliver these benefits, and do so without increasing the deficit. The question Vermonters need to ask is, are the folks in Montpelier really competent to do so?

Who Voted For This Language?

Click HERE to see the final House roll call vote for H.202 (Act 48), passed 94-49, May 5, 2011.

Click HERE to see the final Senate roll call vote for H.202 (Act 48), passed 21-9, May 3, 2011

It is important to note that the federal government is under no obligation to give Vermont these waivers, and it appears that they will not.

Federal Help

In order to help assure Vermont receives the federal waivers sought, Senator Bernie Sanders submitted federal legislation (S. 915) in 2011 that would require states to set up single payer systems with federal funds folded into the programs.

Language in Sanders bill states:

“There is hereby established in the United States a State-Based American Health Security Program to be administered by the individual States in accordance with Federal standards specified in, or established under, this Act…. In order for a State to be eligible to receive payment under sectiona State shall establish a State health security program in accordance with this Act.”

And:

“Board shall establish a national health security budget, which, (A) specifies the total expenditures (including expenditures for administrative costs) to be made by the Federal Government and the States for covered health care services under this Act; and (B) allocates those expenditures among the States.”

Then, in December 2013, Sanders introduced another bill with the same purpose(S. 1782), which would create “…the establishment of a national American Health Security Program (the Program) that requires each participating state to set up and administer a state single payer health program. The Program… incorporates Medicare, Medicaid, the Children’s Health Insurance Program, the Federal Employees Health Benefits Program and TRICARE…,” according to the bill’s summary.

VIDEO: Press Conference in Montpelier in which Vermont’s federal delegation pledges to help Vermont obtain federal waivers for single payer implementation.

Speaking of Getting Those Waivers

In 2012, Peter Shumlin actually wanted to obtain waivers earlier than the 2017 date allowed by the Affordable Care Act. In a VPR interview he said, “I want to see it [Green Mountain Care] implemented by 2016. If it’s sooner that’s better for all of us…. There’s got to be a Vermont way to find a way around those obstacles [waivers]. We can outsmart the feds.” (VPR, 7/16/12)

In November 2013, Gov. Peter Shumlin attended a meeting of Physicians for a National Health Plan in Boston last November where he was confronted by Dr. David Himmelstein. Himmelstein’s complaint about Green Mountain Care was that it couldn’t really be a single-payer system because the Vermont system would also have to accommodate several other insurance plans, including those of federal employees, military personnel, ERISA and Medicare.

Shumlin replied, “But I’m going to try to get the waivers to get everybody [in Vermont] in the pool — everybody. I want everybody in the pool.” This includes seniors currently on Medicare.

Note: If Vermont fails to get the the waivers to bring Medicare and other federal programs into Green Mountain Care (which appears likely to certain), Himmelstein’s criticism is valid. GMC’s status as a “single” payer system, as well as potential savings from more streamline system, would be null and void.

Act 144

In May of 2014, Act 48 was amended by Act 144. Sec. 6 of that Act repealed 33 VSA 1827 (e) and amended the following subsection (f) to read: “Green Mountain Care shall be the payer of last resort with respect to any health service that may be covered in whole or in part by any other health benefit plan, including Medicare, private health insurance, retiree health benefits, or federal health benefit plans offered by the military, or to federal employees.”

Note: As of this writing (10/26/14) Vermont’s online statutes have not been updated to reflect this change, adding to the confusion over this issue).

Some supporters of Act 48 are now saying this change absolves them from any original “take over” intent. (A “We were against it after we were for it” defense.)

Who Voted for this language:

Click HERE to see the final House vote on H.596 (Act 144), passed 83-45 May 5, 2014

No roll call was taken in the Senate.

Seeking Waivers

Despite changes in the law brought forward by Act 144, in September 2014 Gov. Peter Shumlin and his top health care officials, Robin Lunge, director of health care reform; Lawrence Miller, chief of health care reform; Al Gobeille, chair of the Green Mountain Care Board; and Anya Rader-Wallack, traveled to Washington, D.C. to discuss obtaining waivers to federal programs that would allow Vermont to move forward with a single-payer health care program. According the the Affordable Care Act, these waivers cannot be granted until 2017 at the earliest. (VT Digger, 10/1/14)

Conclusions

No wonder Vermonters are confused!

Although the legislature did repeal the “shall seek permission” language from Vermont statute, the new language does not bar Vermont from seeking those waivers. It is worth noting that Governor Shumlin and his healthcare team went to Washington to discuss getting these waivers four months after passage of Act 144.

Nevertheless, it does not appear likely (nor did it ever) that those waivers will be coming for both practical and political reasons.

Was the intent of those who voted for Act 48 in 2011 to “take over” Medicare. Yes. Is it still their intent? Maybe. Whether passage of Act 148 represented a true change of heart, an election year conversion, or simply a change in strategy to “outsmart the feds” is unknown. Passage of Act 144 does not preclude further attempts in this direction.

The secrecy with which the Administration and proponents single payer healthcare have surrounded almost every aspect of this law has not been helpful to citizens trying to make sense of a complicated issue that will effect us all in a profound way. Vermonters deserve better.

If you believe this is an important issue that deserves more attention and more hard questions than the media is willing to give or ask, please support EAI’s efforts with a generous and much appreciated donation. Radio time costs between $17 and $31 per minute. Sponsor a spot!

Recently I watched a speech by Gov. Shumlin wherein he decried the fact that under our current health care system, people of high means pay the very same health insurance rates as those of lesser means. It occurred to me that in so doing, Mr. Shumlin revealed his exact agenda for the government takeover of our health care. That is that only by taking over our health care can government inject itself as Robin Hood into the health care system, putting itself into position to be seen as the savior to the masses for robbing Peter to pay Paul, and thereby keep Paul voting their way of course. Actual results of single payer health care may vary, as anyone above 6th grade knows.

Consider this. If someone arrives at the supermarket in a BMW, do they pay more for their groceries than someone who takes their groceries home in a Kia? Of course not. Silly, right? And unfair too, right? Why? Because the supermarket is a free enterprise, and its management understands that to compete in the marketplace, it must treat all customers fairly or it will lose them to the competition.

Aha!!! The government has no competition, and it wants none. So when it wants a higher degree of control on citizens, what does it do? Well, as we have witnessed, it identifies the subject service of its takeover as a “human right.” Voila! Now it can do as it pleases, which in the health care context includes prohibiting competition, telling you what procedures you can and cannot have, making you pay for sex change operations you will never have, making you pay for reproductive “rights” that may be counter to your religion, etc. We saw how this was done with education merely by activist judges declaring our existing education funding system “unconstitutional” and handing the reigns of a socialist education funding structure to the activist Legislature. Recall the first thing it did was implement a system of property tax based on “ability to pay.” Socialism, for those who might not catch the nuance.

Back to the food comparison, how difficult is it to believe that if the government can declare health care a “human right,” it would not declare eating good food a human right, and thereby initiate a takeover of that industry as well? I do not find it out of the question at all, and I guarantee there would be no shortage of automatons lined up to “fight” for such an effort, and to demand that the “rich” pay their “fair share,” which of course means subsidizing the food of those less inclined toward work and productivity, no just those truly unable to fully provide for themselves.

I hope as unthinking citizens march happily down the road to serfdom (deference to FA Hayek) they are aware that the corollary to “A government that robs Peter to pay Paul can always count on the support of Paul” is “A government big enough to give you everything you want is big enough to take it all away.”

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The Ethan Allen Institute is Vermont’s free-market public policy research and education organization. Founded in 1993, we are one of fifty-plus similar but independent state-level, public policy organizations around the country which exchange ideas and information through the State Policy Network.Read more...